Provider Demographics
NPI:1396362703
Name:UPWARD MOTION REHABILITATION PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:UPWARD MOTION REHABILITATION PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATIMAH
Authorized Official - Middle Name:U
Authorized Official - Last Name:DAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT PT
Authorized Official - Phone:347-486-7789
Mailing Address - Street 1:PO BOX 1681
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-8481
Mailing Address - Country:US
Mailing Address - Phone:347-486-7789
Mailing Address - Fax:929-456-5138
Practice Address - Street 1:554 GRANT AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1329
Practice Address - Country:US
Practice Address - Phone:347-486-7789
Practice Address - Fax:929-456-5138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY029347-1OtherLICENSE